Individual provider Active NPI

Marlene Nelma Mahipat, D.C.

  • Chiropractor
  • Randallstown, MD
National Provider Identifier
1659424976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S02090 Issued in MD
Practice address
5310 Old Court Rd
Suite 301
Randallstown, MD 21133-5243
Phone
(410) 655-8900
Fax
(410) 655-0498
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S02090 MD Primary

Addresses

Primary practice location

5310 Old Court Rd
Suite 301
Randallstown, MD 21133-5243

Mailing address

5310 Old Court Rd
Suite 301
Randallstown, MD 21133-5243
Phone (410) 655-8900

Other identifiers 5

IdentifierTypeStateIssuer
101943OtherMDPRIORITY PARTNERS AND EHP
666069OtherMDACN GROUP
4J6260001OtherDCBLUE CROSS BLUE SHIELD
7491554OtherMDAETNA
666069OtherMDUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000012 MD Practitioner - Chiropractic 8123099827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5310 Old Court Rd
Suite 301
Randallstown, MD 21133-6202
Phone (410) 655-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S02090MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mediquest, LLC Chiropractor CurrentSince May 3, 2004 Accepting new patients
Maryland Physicians Associates Past Accepting new patients
Maryland Healthcare Clinics Chiropractor Past Accepting new patients

Locations

5310 Old Court Rd
Ste 301
Randallstown, MD 21133
Phone (410) 655-8900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659424976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD",
            "address_2": "SUITE 301",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335243",
            "telephone_number": "410-655-8900",
            "fax_number": "410-655-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD",
            "address_2": "SUITE 301",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335243",
            "telephone_number": "410-655-8900",
            "fax_number": "410-655-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHIPAT",
        "first_name": "MARLENE",
        "middle_name": "NELMA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S02090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY PARTNERS AND EHP",
            "identifier": "101943",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "666069",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4J6260001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7491554",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "666069",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.